Prosthetic Aortic Valve Stenosis in End-Stage Renal Failure
Figure 1
(a) shows short-axis images of the aortic valve prosthesis. (A) is the aortic valve prosthesis 5 years after implantation demonstrating minimal calcification and thin, barely visible, leaflets. Shown on (B) is the prosthetic aortic valve about 2-years after beginning dialysis demonstrating heavy leaflet calcification (arrows). (b) shows the aortic valve prosthetic mean gradient by spectral continuous wave Doppler echocardiography demonstrating a normal gradient 5 years after implantation (A) and a markedly increased gradient shortly after beginning dialysis (B), corresponding to the images in (a). (c) shows the intraoperative transesophageal echocardiographic images of the stenotic aortic valve prosthesis at the time of the second aortic valve operation. Short-axis image on the left (A) and long-axis image on the right (B) demonstrate marked leaflet calcification, thickening, and severe stenosis.
